PIH Nursing Team Efforts Help COPE Educate Community Health Reps

The Indian Health Service funds the CHR program. With home healthcare visits, the representatives help 286 chronically ill and isolated individuals on the Navajo Nation in Arizona and New Mexico better manage illnesses and improve their health.

COPE partners with Indian Health Service physicians, public health nurses, diabetes educators and other providers to lead training sessions — more than 115 to date — on chronic disease management for the representatives, according to COPE’s 2013 Annual Report.

COPE was launched in 2009 and is a partnership between the Navajo Nation Community Health Representative Program, Indian Health Service, Brigham and Women’s Hospital and Partners
In Health.

“The Partners In Health argument is that it is important to deliver healthcare to the most vulnerable, but often because of poverty and isolation, they cannot get in to see a provider,” said Sonya Shin, COPE director, associate physician at Brigham and Women’s Hospital, and assistant professor at Harvard Medical School. “The CHRs are an extension of the healthcare system into the community.”

According to Partners In Health’s director of global nursing Sheila Davis, RN, DNP, ANP-BC, FAAN, COPE-provided training helps the representatives better explain medical information to patients and helps them set achievable health goals and relay the realities of a patient’s home situation back to the healthcare providers.

“The CHR, CHW can help the patient make the best decision [possible] with the medical advice they have been given,” Davis said. “If someone has heart disease or diabetes, for example, and are advised to make dietary changes, the CHR can help patients make different decisions, where able, [by] choosing canned fruit not in heavy syrup, or [to use] leaner ways of cooking, etc.

“A CHR can also play an important role in educating providers about limitations patients may have in the community and help figure out the best way to handle ongoing care needs,” Davis said.

Representatives also help physicians and nurses in the eight Navajo Area Indian Health Service units in New Mexico and Arizona better serve patients with suggestions to group together appointments to eliminate the need for multiple trips as many individuals drive at least 50 miles to see a provider at an IHS hospital or clinic, to consider alternatives if a patient is having problems adhering to a medication schedule and to use pictures to illustrate instructions if a patient is illiterate.

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